院前轻度亚低温治疗严重创伤性脑损伤患者。

Pre-hospital mild therapeutic hypothermia for patients with severe traumatic brain injury.

机构信息

Department of Neurosurgery, Affiliated Hospital of Hangzhou Normal University, Zhejiang, People's Republic of China.

Department of Emergency, Affiliated Hospital of Hangzhou Normal University, Zhejiang, People's Republic of China.

出版信息

Brain Inj. 2022 Jan 2;36(1):72-76. doi: 10.1080/02699052.2022.2034946. Epub 2022 Feb 10.

DOI:10.1080/02699052.2022.2034946

PMID:35143363

Abstract

BACKGROUND

We aimed to assess the effects of pre-hospital mild therapeutic hypothermia (MTH) on patients with severe traumatic brain injury (sTBI).

METHODS

Eighty-six patients with sTBI were prospectively enrolled into the pre-hospital MTH group and the late MTH group (initiated in hospital). Patients in the pre-hospital MTH group were maintained at a tympanic temperature of 33°C-35°C before admission and continued to be treated with a therapeutic hypothermia device for 4 days. Patients in the late MTH group were treated with the same MTH parameters. Intracranial pressure (ICP), complications and Glasgow Outcome Scale (GOS) scores were monitored.

RESULTS

ICP was significantly lower for patients in the pre-hospital MTH group 24, 48, and 72 h after treatment (17.38 ± 4.88 mmHg, 18.40 ± 4.50 mmHg, and 16.40 ± 4.13 mmHg, respectively) than that in the late MTH group (20.63 ± 3.00 mmHg, 21.80 ± 6.00 mmHg, and 18.81 ± 4.50 mmHg) ( < .05). The favorable prognosis (GOS scores 4-5) rate in the pre-hospital MTH group was higher tha n the late MTH group (65.1% vs. 37.2%, respectively; P < .05) without complications .

CONCLUSION

Pre-hospital MTH for patients with STBI can reduce ICP and improve neurological outcomes.

摘要

背景

本研究旨在评估院前轻度亚低温（MTH）对严重颅脑创伤（sTBI）患者的影响。

方法

86 例 sTBI 患者前瞻性纳入院前 MTH 组和院内晚期 MTH 组。院前 MTH 组患者于入院前将鼓室温度维持在 33°C-35°C，并持续使用治疗性低温设备治疗 4 天。晚期 MTH 组患者采用相同的 MTH 参数治疗。监测颅内压（ICP）、并发症和格拉斯哥预后评分（GOS）。

结果

治疗后 24、48 和 72 h，院前 MTH 组患者的 ICP 分别为 17.38±4.88 mmHg、18.40±4.50 mmHg 和 16.40±4.13 mmHg，明显低于晚期 MTH 组（20.63±3.00 mmHg、21.80±6.00 mmHg 和 18.81±4.50 mmHg）（<0.05）。院前 MTH 组预后良好（GOS 评分 4-5）率明显高于晚期 MTH 组（65.1% vs. 37.2%；P<0.05），且无并发症发生。